Stavros Nicholas Maltezos, M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Practice address

3825 Highland Ave
Tower 1, Suite 5M
Downers Grove, IL 60515-1552

Phone

(630) 725-9890

Fax

(630) 725-0988

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mount Sinai Community Foundation

  • Rehabilitation Hospital
  • Chicago, IL
  • NPI 1376715896
  Medicare reassignment NPD
• CNS Neurological Surgery SC

  • Neurological Surgery Physician
  • Downers Grove, IL
  • NPI 1679654743
  NPD (past) Authorized official
• Mount Sinai Community Foundation

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1780094508
  NPD
• Mount Sinai Community Foundation

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1982657854
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1902987076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 2299 PAYSPHERE CIRCLE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60674",
            "telephone_number": "630-725-9890",
            "fax_number": "630-725-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 HIGHLAND AVE",
            "address_2": "TOWER 1, SUITE 5M",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151552",
            "telephone_number": "630-725-9890",
            "fax_number": "630-725-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALTEZOS",
        "first_name": "STAVROS",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF ILLINOIS",
            "identifier": "0001617783",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam John Mallinger, D.O.
• Jenelle L Mallios Gialousakis, O.D.
• Erica Malloy
• Marsha Maloloyon
• Grace Nelson Maloney
• Claire Maly
• Aaron Mangin
• Lisa Manhart, LCSW
• Maninder Express Corp
• Shelly Ann Mann, MD

• Neurological Surgery Physician in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Neurological Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.